Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2022; 14(9): 555-563
Published online Sep 16, 2022. doi: 10.4253/wjge.v14.i9.555
Clinical profile, diagnostic yield, and procedural outcomes of single balloon enteroscopy: A tertiary care hospital experience
Maha Inam, Masood M Karim, Umar Tariq, Faisal Wasim Ismail
Maha Inam, Umar Tariq, Medical College, Aga Khan University Hospital, Karachi 74800, Pakistan
Masood M Karim, Faisal Wasim Ismail, Department of Medicine, Aga Khan University Hospital, Karachi 74800, Pakistan
Author contributions: Inam M participated in the acquisition, analysis, and interpretation of the data, and assisted in manuscript writing and review; Karim MM participated in the acquisition and interpretation of the data, and assisted in manuscript writing and review; Tariq U participated in the acquisition of the data and assisted in manuscript writing and review; Ismail FW conceptualized, designed, and supervised the study, participated in the acquisition and interpretation of the data, and assisted in manuscript writing and review; all authors have read and approved the final manuscript.
Institutional review board statement: Approval was obtained for this study from the Ethical Review Committee of the Aga Khan University Hospital, Karachi, Pakistan.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Faisal Wasim Ismail, FACG, FACP, FCPS, MBBS, Associate Professor, Department of Medicine, Aga Khan University Hospital, National Stadium Road, Karachi 74800, Pakistan. faisal.ismail@aku.edu
Received: April 16, 2022
Peer-review started: April 16, 2022
First decision: May 12, 2022
Revised: May 21, 2022
Accepted: August 10, 2022
Article in press: August 10, 2022
Published online: September 16, 2022
Processing time: 151 Days and 10.2 Hours
Abstract
BACKGROUND

Single balloon enteroscopy (SBE) allows ease of access for small bowel visualization and has multiple diagnostic and therapeutic indications. It provides the advantage of performing various therapeutic interventions alongside the diagnostic procedure. SBE has also been considered a relatively safe procedure with no major complications.

AIM

To investigate the indications, safety, and clinical yield of SBE, and determine its effect on disease outcome.

METHODS

A retrospective, descriptive study was conducted at a tertiary care hospital in Karachi, Pakistan. Medical records of 56 adult patients (≥ 18 years) who underwent SBE between July 2013 and December 2021 were reviewed and data were collected using a structured proforma. A descriptive analysis of the variables was performed using Statistical Package of Social Sciences Version 19. Results are reported as the mean ± SD for quantitative variables and numbers and percentages for qualitative variables. Missing data are reported as unknown.

RESULTS

A total of 56 patients who underwent 61 SBE procedures were included. The mean age was 50.93 ± 16.16 years, with 53.6% of them being males. Hypertension (39.3%) and diabetes mellitus (25.0%) were the most common pre-existing comorbidities. Obscure gastrointestinal bleed (39.3%) was the most common indication for enteroscopy, followed by chronic diarrhea (19.7%) and unexplained anemia (16.4%). The majority of procedures were performed in the endoscopy suite (90.2%) under monitored anaesthesia care (93.4%). Most procedures were diagnostic (91.8%) and completed without complications (95.1%). The depth of examination ranged from 95 cm to 500 cm with a mean of 282.05 ± 90.04 cm. The most common findings were inflammation and ulcerations (29.5%), followed by masses (19.7%) and vascular malformations (14.8%). As a result of the findings, a new diagnosis was made in 47.5% of the cases and a previous one was ruled out in 24.6% of them; 65.6% of the cases had a change in management.

CONCLUSION

SBE is a suitable modality for investigating diseases in the small bowel. It is shown to be technically efficient and reasonably safe and is associated with high diagnostic and therapeutic yield.

Keywords: Single balloon enteroscopy; Small bowel diseases; Gastrointestinal bleed; Small bowel endoscopy; Small bowel; Balloon-assisted enteroscopy

Core Tip: Single balloon enteroscopy (SBE) is a safe and effective modality which allows ease of access for small bowel visualization. The procedure has multiple diagnostic and therapeutic indications. However, there is insufficient data published reporting its efficacy and impact. In this study, we analysed our single centre data of adults who underwent SBE between 2013 and 2021. We report patient demographics, procedure indications, and procedure findings. Based on our results, we can assess the indications, safety, and clinical yield of SBE, and determine its effect on disease outcome.